After having been crowned the diabetes capital of the world - with a whopping 40 million diabetics - India has now segued into the league of nations with the highest number of high blood pressure patients. According to the reputed British medical journal, 'The Lancet', a staggering 150 million Indians - nearly half of them women - suffer from high blood pressure, a precursor to a raft of life-threatening illnesses such as stroke, hemorrhage, diabetes, paralysis and blindness.
"Nowadays, almost every other patient I come across has high blood pressure," admits Dr Sanjay Mahajan, general physician and Consultant, Kailash Hospital, Noida. "The magnitude of the problem is engulfing all sections of society and we need to tackle it on a war footing."
High blood pressure, according to Dr Mahajan, is a lifestyle-linked disorder triggered by smoking, alcohol abuse, obesity, high salt intake, lack of exercise, and stress. "It is also genetic," he adds. "Family history of hypertension and stroke can trigger high blood pressure which - if untreated - can climax in a fatal heart attack or brain stroke."
Hypertension or blood pressure, also known as the silent killer or the scourge of modern times, afflicts 40 per cent of the urban Indian populace and 10 per cent of the rural populace. According to Dr Anoop Mishra of Fortis Hospital, New Delhi, hypertension accounts for 57 per cent of deaths in India due to stroke and 24 per cent of deaths caused by heart attack.
But what is blood pressure and how does it impact one's health? Blood pressure is the force of the blood pushing against the walls of the arteries. Each time the heart beats (about 60-70 times a minute, at rest), it pumps blood into the arteries. Blood pressure is at its highest when the heart beats while pumping blood. This is called "systolic pressure". Between heart beats, the pressure falls and is termed "diastolic pressure".
Both are important, according to doctors. Blood pressure keeps fluctuating through the course of the day, dropping when one rests and rising when one is active. It also gets spiked when one is excited, nervous or active. Still, for most of one's waking hours, the blood pressure stays pretty much the same. This level, recommend doctors, should be lower than 120/80. When the level stays high, 140/90 or higher, it is technically termed as high blood pressure. "With high blood pressure," explains Dr Mahajan, "the heart has to work harder, the arteries are put under tremendous pressure and chances of getting a stroke, heart attack and kidney problems magnify."
Unfortunately, there's no single cause for high blood pressure, also known as primary blood pressure. In some people, high blood pressure could be the manifestation of another medical problem or medication. However, even after one's blood pressure stabilizes (due to medication, lifestyle modification or both), and one is under treatment for it, doctors still consider one as a patient even if one registers repeated readings in the normal range.
According to the 'International Journal of Medical Sciences (2007), the prevalence of hypertension has increased by about 30 times among urban dwellers in India and about 10 times amongst the villagers. Various factors have fuelled this rising trend - urbanization, diet, stress, increased population, and shrinking employment opportunities being some of them.
Amongst women, the primary causes of blood pressure are professional / relationship stress, a sedentary lifestyle and improper eating habits. Another associated cause, point out gynecologists, is menopause. "With advancing age and menopause," elaborates gynecologist and obstetrician Dr Tripat Chowdhury of Spring Meadows Hospital, New Delhi, "a woman's level of estrogen (steroid hormones) plummets. This causes hardening of the arteries which impacts blood pressure levels too."
According to research, the consumption of oral contraceptives also has a bearing on a woman's blood pressure levels. In fact, a nurses' health study in the US has established that high blood pressure is two to three times more common in women taking oral contraceptives, for five years or longer, than in those not consuming them.
The study, investigating the risk of developing high blood pressure from taking oral contraceptives, followed the health trajectory of more than 100,000 American nurses who were asked about use of oral contraceptives and their blood pressure on three occasions over a four-year period. The principal finding was that hypertension was about 80 per cent higher in the women taking oral contraceptives for more than six years.
However, given today's lifestyle and work pressures, there's no denying that a modern woman is under a lot of stress from multiple quarters. This stress gets further magnified in the Indian context due to socio-economic factors like the changing dynamics of the family structure, lack of reliable domestic help, increased pressure at the workplace to get ahead and relationship stress.
But, as doctors advise, keep it simple. "Indian women are victims of the superwoman syndrome," opines Dr Neelanjana Singh, Consultant Dietician, Pushpawati Singhania Research Institute, New Delhi. "They need to lighten up a bit, find some quality 'me' time and exercise as often as they can. Their diet should include lots of whole grains, fruits, veggies, nuts, minerals and vitamins. This can be their complete arsenal against high blood pressure in these stress-ridden times."